﻿<html>
<head>
<script type="text/javascript">

    function validate(form) {
        if (form.firstname.value == "") {
            alert("Please entry your First Name");
            return false;
        }
        if (form.lastname.value == "") {
            alert("Please entry your Last Name");
            return false;
        }

        if (form.password.value == "") {
            alert("Please entry your password");
            return false;
        }

        if (form.password.value.length < 8) {
            alert("Password must be of 8 character");
            return false;
        }
        if (form.address1.value == "") {
            alert("Please entry your stree Address1");
            return false;
        }
        if (form.street2.value == "") {
            alert("Please entry your stree Address2");
            return false;
        }
        if (form.postal.value == "") {
            alert("Please entry your Postal Address");
            return false;
        }

        if (form.phone.value == "") {
            alert("Please entry your Phone");
            return false;
        }
        if (form.country1.value == "0") {
            alert("Please select your country");
            return false;
        }

        if (form.state.value == "") {
            alert("Please select your state");
            return false;
        }
        if (form.title.value == "") {
            alert("Please select your title");
            return false;
        }

        if (form.check.checked == false) {
            alert("Please select your newsfield");
            return false;
        }
        return true;
    }
</script>


</head>
<body>
<div class="contenttitle">
  <h2 class="form"><span>Contact Information</span></h2>
</div>
<!--contenttitle--> 
<br />
<p>This page allows you to keep the EssenceAnalytics system up to date with regard to your contact details. Keeping this section up to date will help you to get the most out of the EssenceAnalytics System.</p>
<br />
<form id="form1" class="stdform stdform2" method="post" action="" onsubmit="validate(this)">
  <p>
    <label>First Name</label>
    <span class="field">
    <input type="text" name="firstname" id="firstname" class="longinput" />
    </span> </p>
  <p>
    <label>Last Name</label>
    <span class="field">
    <input type="text" name="lastname" id="lastname" class="longinput" />
    </span> </p>
  <p>
    <label>Email</label>
    <span class="field">
    <input type="text" name="email1" id="email1" class="longinput"/>
    </span> </p>
  <p><label>Password</label>
    <span class="field">
    <input type="password" name="password" id="email" class="longinput" />
    </span></p>
  <p>
    <label>Title/Position </label>
    <span class="field">
    <select name="title" id="selection">
      <option value="">Choose One</option>
      <option value="1">Selection One</option>
      <option value="2">Selection Two</option>
      <option value="3">Selection Three</option>
      <option value="4">Selection Four</option>
    </select>
    </span> </p>
     <p>
    <label>Street Address1</label>
    <span class="field">
    <input type="text" name="address1" id="address1" class="longinput" />
    </span> </p>
  <p>
    <label>Street Address2</label>
    <span class="field">
    <input type="text" name="street2" id="address2" class="longinput" />
    </span> </p>
    
    <p>
    <label>Country </label>
    <span class="field">
    <select name="country1" id="country1">
      <option value="0">Choose One</option>
      <option value="1">Selection One</option>
      <option value="2">Selection Two</option>
      <option value="3">Selection Three</option>
      <option value="4">Selection Four</option>
    </select>
    </span> </p>
    <p>
    <label>State </label>
    <span class="field">
    <select name="state" id="selection">
      <option value="">Choose One</option>
      <option value="1">Selection One</option>
      <option value="2">Selection Two</option>
      <option value="3">Selection Three</option>
      <option value="4">Selection Four</option>
    </select>
    </span> </p>
    <p>
    <label>Postal Code</label>
    <span class="field">
    <input type="text" name="postal" id="address2" class="longinput" />
    </span> </p>
    <p>
        <label>Phone</label>
        <span class="field">
            <input type="text" name="phone" id="address2" class="longinput" />
        </span> </p>

    <p><label>Newsletter Signup</label>
        <span class="field">
                  <input type="checkbox" name="check" /> 
        Subscribe to EssenceAnalytics newsletter</span>
    </p>
  <p><span class="field">
    <button class="submit radius2">Submit Button</button></span>
  </p>
</form>
<br clear="all" />
<br />
</body>
</html>
